The typical Parkinson’s tremor occurs mostly at rest (“resting tremor”) and lessens during sleep and when the body part is actively in use. For example, your hand might shake while you’re sitting, or even while you’re walking, but when you reach out to shake hands with someone, the tremor is less noticeable or goes away entirely.
A tremor tends to occur in the hands and is often described as “pill-rolling”: imagine holding a pill between your thumb and forefinger and continuously rolling it around. But it can also appear in other parts of the body, including the lower lip, jaw or leg. These tremors can interfere with routine activities such as shaving, dressing, writing and many other tasks that require fine motor coordination.
Some people report an internal tremor, a shaking sensation inside the chest, abdomen or limbs that cannot be seen.
A tremor usually affects only one side of the body, especially during early stages of the disease. With disease progression both sides may become affected. Fatigue, stress or intense emotions can temporarily make tremors worse.
A tremor caused by Parkinson’s can appear in 2 ways:
A resting tremor: This might happen when your body is still and relaxed, for example when you’re lying in bed. The most typical tremor in Parkinson’s is called a ‘pill-rolling’ rest tremor, as it looks like you are trying to roll a pill between your thumb and index finger.
An action tremor: This can happen when you’re doing something, like trying to hold a magazine or drink from a cup.
Parkinson’s disease is caused by a loss of nerve cells in part of the brain called the substantia nigra. This leads to a reduction in a chemical called dopamine in the brain.
Dopamine plays a vital role in regulating the movement of the body. A reduction in dopamine is responsible for many of the symptoms of Parkinson’s disease.
Exactly what causes the loss of nerve cells is unclear. Most experts think that a combination of genetic and environmental factors is responsible.
It’s thought around 1 in 500 people are affected by Parkinson’s disease.
Most people with Parkinson’s start to develop symptoms when they’re over 50, although around 1 in 20 people with the condition first experience symptoms when they’re under 40.
Men are slightly more likely to get Parkinson’s disease than women.
The first step to living well with Parkinson’s disease is to understand the disease and the progression:
It is possible to have a good to great quality of life with PD. Working with your doctor and following recommended therapies are essential in successfully treating symptoms by using dopaminergic medications. People with PD need this medication because they have low levels or are missing dopamine in the brain, mainly due to impairment of neurons in the substantia nigra.
It is important to understand that people with PD first start experiencing symptoms later in the course of the disease because a significant amount of the substantia nigra neurons have already been lost or impaired. Lewy bodies (accumulation of abnormal alpha-synuclein) are found in substantia nigra neurons of PD patients.
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